CBT aims to recognize negative thoughts and the harmful behaviors they lead to, reshape how you interpret things, put them in context, and develop healthy and positive ways to express those thoughts through words and actions. Identifying personal triggers for relapse is the first step in developing an effective RP plan. Triggers can be internal, such as emotions and thoughts, or external, such as people, places, and situations. Mindfulness-Based Relapse Prevention (MBRP) integrates mindfulness practices with traditional RP strategies. MBRP focuses on increasing awareness of thoughts, feelings, and bodily sensations in a nonjudgmental manner, helping individuals respond more effectively to triggers and cravings.
- Improving self-reliance and confidence is an integral part of relapse prevention.
- Examples of high-risk contexts include emotional or cognitive states (e.g., negative affect, diminished self-efficacy), environmental contingencies (e.g., conditioned drug cues), or physiological states (e.g., acute withdrawal).
- Conversely, a return to the target behavior can undermine self-efficacy, increasing the risk of future lapses.
- In a meta-analysis by Carroll, more than 24 RCT’s have been evaluated for the effectiveness of RP on substance use outcomes.
- Despite precautions and preparations, many clients committed to abstinence will experience a lapse after initiating abstinence.
Whether a high-risk situation culminates in a lapse depends largely on the individual’s capacity to enact an effective coping response–defined as any cognitive or behavioral compensatory strategy that reduces the likelihood of lapsing. These strategies also focus on enhancing the client’s awareness of cognitive, emotional, and behavioral reactions in order to prevent a lapse from escalating into a relapse. The first step in this process is to teach clients the RP model and to give them a “big picture” view of the relapse process. For example, the therapist can use the metaphor of behavior change as a journey that includes both easy and difficult stretches of highway and for which various “road signs” (e.g., “warning signals”) are available to provide guidance. According to this metaphor, learning to anticipate and plan for high-risk situations during recovery from alcoholism is equivalent to having a good road map, a well-equipped tool box, a full tank of gas, and a spare tire in good condition for the journey.
Strategies for Effective Relapse Prevention
A setback does not have to end in relapse to be worthy of discussion in therapy. Clinical experience has shown that when clients are under stress, they tend to glamorize their past use and think about it longingly. The cognitive challenge is to acknowledge that recovery is sometimes hard work but addiction is even harder. If addiction were so easy, people wouldn’t want to quit and wouldn’t have to quit. The belief is that recovery requires some special strength or willpower that the individual does not possess.
The Role of Spirituality in Addiction Recovery
These situations include, for example, social pressures and emotional states that could lead to thoughts about using substances, and ultimately to cravings and urges to use. Yes, relapse prevention techniques can be adapted for various types of addiction, including alcohol, opioids, and other substances. While the core principles remain the same, specific strategies may need to be tailored to address the unique challenges of different substances.
Managing Cravings for Drugs & Alcohol with Mindfulness
While a support system and help from other people can help stop a relapse at any stage, there will be times when other people aren’t available. Trusting your instincts and making informed choices to maintain your recovery and prevent relapse are invaluable skills CBT teaches you. Cognitive-behavioral therapy helps successfully treat various mental health issues, traumatic experiences, alcohol dependence, addictive behaviors, and substance abuse. Relapse prevention (RP) is a mindfulness-based cognitive therapy that helps identify high-risk situations that could trigger a relapse and ways for a person to overcome them and maintain the positive outcomes and changes they’ve made.
The benefits of outpatient addiction treatment programs
Second, recovery is a process of personal growth with developmental milestones. Third, the main tools of relapse prevention are cognitive therapy and mind-body relaxation, which change negative thinking and develop healthy coping skills 3. Educating clients in these few rules can help them focus on what is important. One critical goal will be to integrate empirically supported substance use interventions in the context of continuing care models of treatment delivery, which in many cases requires adapting existing treatments to facilitate sustained delivery 140.
- The transition between emotional and mental relapse is not arbitrary, but the natural consequence of prolonged, poor self-care.
- Global self-management strategy involves encouraging clients to pursue again those previously satisfying, nondrinking recreational activities.
- There’s a wealth of insight in slips, and they are crucial for thriving in sobriety.
- The model uses cognitive behavioural approaches to support the person in identifying thoughts and feelings they have.
- One particularly notable innovation to the Relapse Prevention (RP) model is Mindfulness-Based Relapse Prevention (MBRP).
Probably the most important thing to understand about post-acute withdrawal is its prolonged duration, which can last up to 2 years 1,20. It is not unusual to have no symptoms for 1 to 2 weeks, only to get hit again 1. This is when people are at risk of relapse, when they are unprepared for the protracted nature of post-acute withdrawal. Clinical experience has shown that when clients struggle with post-acute withdrawal, they tend to catastrophize their chances of recovery. The cognitive challenge is to encourage clients to measure their progress month-to-month rather than day-to-day or week-to-week. There are many risks to recovery at this stage, including physical cravings, poor self-care, wanting to use just one more time, and struggling with what is the relapse prevention model whether one has an addiction.
Research has shown that feeling lonely, depressed, angry, and stressed are all correlated with relapse. For example, a teen who experiences a rejection at school, or a major break-up, may feel an urge to turn to familiar drugs they used to use to numb the pain. During treatment, relapse prevention helps patients learn how to recognize these emotional states, and how to manage them quickly before they spiral into one’s former target behaviors. Second, mind-body relaxation helps individuals let go of negative thinking such as dwelling on the past or worrying about the future, which are triggers for relapse. The practice of self-care during mind-body relaxation translates into self-care in the rest of life.
This helps enhance decision-making and impulse control, which often diminish because of addiction’s effects on the brain. You must also develop healthy coping skills and an effective relapse prevention plan. Self-efficacy (SE), the perceived ability to enact a given behavior in a specified context 26, is a principal determinant of health behavior according to social-cognitive theories. Although SE is proposed as a fluctuating and dynamic construct 26, most studies rely on static measures of SE, preventing evaluation of within-person changes over time or contexts 43.
During stressful moments an addicted person would usually turn to the substance. This theory indicates that where a person has developed healthy coping skills, they have more chances of remaining abstinent. Addiction treatment using the RP model assesses the patient’s environment and emotional state.
In the absence of other non-drinking pleasurable activities, the person may view drinking as the only means of obtaining pleasure or escaping pain. In many cases, initial lapses occur in high-risk situations that are completely unexpected and for which the drinker is often unprepared. In relapse “set ups,” however, it may be possible to identify a series of covert decisions or choices, each of them seemingly inconsequential, which in combination set the person up for situations with overwhelmingly high risk. These choices have been termed “apparently irrelevant decisions” (AIDs), because they may not be overtly recognized as related to relapse but nevertheless help move the person closer to the brink of relapse. Relapse prevention is a structured approach to identifying triggers, developing coping strategies, and maintaining long-term sobriety through therapy, support groups, and personal growth.